Provider Demographics
NPI:1982986659
Name:GOMEZ GOMEZ, VERONICA DEL CARMEN (MD)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:DEL CARMEN
Last Name:GOMEZ GOMEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 LAFAYETTE AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4906
Mailing Address - Country:US
Mailing Address - Phone:347-439-8713
Mailing Address - Fax:
Practice Address - Street 1:1280 DEKALB AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-3204
Practice Address - Country:US
Practice Address - Phone:718-455-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine